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Minnesota rates for HCPCS A2013

InnovaMatrix FS, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,348.96 / $1,513.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,089.30 / $2,187.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $125.89 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $602.56 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $173.78 / $186.21
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $169.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $2,570.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,348.96 / $1,862.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $1,288.25 / $1,479.11